为低albuminemia纠正波萨可纳的度
David E Nix1, Fekade Sime2, Jason A Roberts2,3,4,5
1Department of Pharmacy Practice and Science, R. Ken Coit College of Pharmacy, The University of Arizona, Tucson, Arizona, USA.
Pharmacotherapy
|April 19, 2025
概括
低albuminemia降低了波萨可纳的总水平,但未结合的药物度保持稳定. 调整总体波萨可纳水平对白蛋白的调整对于准确的治疗药物监测和避免毒性至关重要.
科学领域:
- 药理学 药理学是指药理学的学科.
- 临床化学 临床化学
背景情况:
- 波萨可纳是一种高度与蛋白质结合的药物 (>98%) 经常使用治疗药物监测 (TDM) 进行监测.
- 低albuminemia可能会导致较低的测量总度posaconazole,尽管没有预期的变化在活跃的未结合度.
- 波萨可纳的治疗范围是基于总度,可能误解低albuminemic 患者的水平.
研究的目的:
- 为了研究一个方程的实用性,以纠正基于专蛋白水平的波萨可纳度.
- 为了评估与专素纠正的波萨可纳度是否可以作为未结合度测量的替代品.
主要方法:
- 在重症患者中,对非结合性和总度的回顾性分析.
- 使用线性回归来探索总度和未结合度之间的关系,用白蛋白作为共变量.
- 应用了校正方程式来使总度正常化,以达到4.4g/dL的标准白蛋白水平.
主要成果:
- 使用UHPLC-MS/MS.分析了78对总和未结合的波萨科纳度.
- 波萨可纳的中位数未结合分数为0.00645.5.
- 一个简化的校正方程式,Csim = Ct * 4.4/Alb,被提出作为正常化总波萨可纳度的近似值.
结论:
- 低albuminemia与降低的总波萨可纳度有关,但未结合的度通常不受影响.
- 在治疗范围内的波萨可纳的总度可能表明低albuminemic患者的毒性风险.
- 在低albuminemia中准确解释波萨康纳TDM需要考虑白蛋白水平.
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